Death of a pet

Bereavement is divided in grief and mourning. Bereavement happens in humans and also in pets. Veterinarians can help people go through this phase by announcing what may happen, and by offering respect and empathy. After a pet dies or disappears, people
often acquire a new pet. If they are still in their grieving phase, it may facilitate the development of anxiety in the replacement pet. Veterinarians can also help animals going through bereavement.

The death of a pet will cause a bereavement reaction in the owners or in other pets that used to live with him. What is the bereavement reaction and how can a veterinarian prevent that it becomes complicated or pathological is one subject of this
article. The other is to discuss what may happen to a pet that is chosen to replace the former one.

The complicated bereavement is a long duration depression disorder (several months to one year) with psychosomatic reactions and suicide attempts. They are accompanied by turbulence in work patterns, social activities and family interactions.

Control: the way one may be able to control the event that causes stress (stressor).

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Feedback: the way one is informed about the evolution of the stressor, when it is about to begin and end, for example.

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Prediction: an anticipated stressor seems to induce less stress than an un-anticipated one. But anxious individuals may suffer from this anticipation process too. So prediction may induce more or less stress depending on the individual.

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Personality: a normal, adaptive individual will cope more easily than a dysthymic, anxious or other type of personality disorder.

The coping process may be decisive for the occurrence of normal and complicated (or pathological) bereavement.

We may hypothesise that bereavement reactions will be proportional to attachment and that hyperattachment (dependence) will probably lead to complicated or pathological bereavement.

Attachment is difficult to define. The level of distress reaction one has to suffer when the attachment individual is away has often defined it.

Attachment is a learning mechanism; it facilitates the identification of a privileged individual (or object) that has safety and appeasing characteristics. It is compelling for a dog, cat or human to develop attachment.

Primary attachment identifies the specific individual (in general the mother or foster-parent) who will become the being around whom imprinting, sensorial, psychomotor, affective and social development will be organised. Secondary attachment
takes place after detachment from the primary attachment being; it is generally multiple and oriented toward individuals, objects and habitats.

Attachment and detachment are normal, complementary, unavoidable processes for the development of the social personality of the animal.

The persistence of a primary attachment facilitates dependence (hyperattachment) and developmental disorders like infantilism and separation anxiety. An excess of secondary attachment facilitates dependence (hyperattachment) and separation or
solitude-related disorders, anxious and mood disorders.

With these definitions in mind, one can understand easily why I hypothesise that:

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The loss of a primary attachment is worse than the loss of a secondary attachment;

There are several affective, cognitive and behavioural long-time reactions that may affect bereavement:

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Minimisation of grief by the survivor because "it’s only an animal" . This cognitive reaction may not be congruent with the affective reaction and the affective reaction could be misunderstood and bound to something else. This may not
be a problem for veterinarians.

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Minimisation of someone's grief by his or her entourage may facilitate redirected anger toward the present and unconcerned individual (the veterinarian) who tries to do his (her) best to explain things.

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Difficulties in the mourning process because of the lack of ritualised mourning (leaving the pets with the veterinarian, no burial, no incineration, …) .

One may think that a family’s grieving may be easier than a single individual grieving. In fact this may not be an important factor. What matters is the specific attachment that tied the human and the animal. The spontaneous solutions found by the
family members may worsen the bereavement of the (hyper) attached individual because of

Everything may be linked to people's representation process. And in this area, people may lie to themselves and say something they do not really believe. And a veterinarian may gather objective information on the cognitive representation by
listening to what people say. If they talk about their pet as "my boy", "my girl", or about themselves as "daddy" or if a child is speaking about his parents as the pet’s "pappy" or "mammy", it may
signify they consider the animal as a human-substitute or full-time family member. Pictures of the animal may also help to gather evidence of a human-substitute animal.

If the veterinarian is able to understand the special role this animal has played in the family as a human substitute, he has to accept and be very tolerant about it, even if it is against his (her) own beliefs, representations or ethics. This is an
obligation of respect toward the grieving people. It is too late at this moment to change their representation. It would have to be done a long time before the death, in particular through a therapy process.

For a child, a pet can be considered as a transitional object. This is a specific object that has symbolic attachment value and helps the child to go through the transition from attachment to the mother and father to attachment to the rest of
the world.

The pet can be the child's best friend and a process of identification may take place.

Grieving for the lost pet becomes a grieving for part of himself that died with the pet.

This is quite perturbing when the pet has been euthanised for behavioural problems, for soiling, for aggression, etc.

The grieving process can be aggravated because of the representation the child is making for the cause of the euthanasia. It is important for the parents to try to get this information out of the child and not to believe that the reason they have given
the child was the reason he has understood and believed. The child may possibly make identification with the cause of death and fear death for himself if he shows one day one or several of the behaviours the pet has been euthanised for, for example
soiling or aggression.

What can you as a veterinarian do to alleviate the bereavement process in people?

1. Announce in advance what will happen to the pet; in the case of euthanasia announce the procedure and the duration of the procedure; adapt the procedure to the owners' needs; adapt the vocabulary to the owners' beliefs.

2. Announce in advance what the bereavement process is.

3. At the moment of euthanasia give the owners time to be alone with the pet.

4. Respect is paramount: respect for the owner's feelings and beliefs; respect for the pet's well being.

5. Empathy is important. Listen to the people. Do not comment or react with your body language (frowning, smiling, shrugging your shoulders, …). Empty your mind of reasoning thoughts, just listen to them. Answer questions. Do not volunteer to
propose solutions. At the moment of death, people do not ask for solutions, they just need to be heard.

6. Mirror the body, vocal and verbal language of the people, the rhythm of their voice, the intonation, and the vocabulary. Respect the dimension the people are in: visual, vocal, and kinaesthetic. Do not speak about visual things if the people
are speaking about sounds and noises. Do not touch somebody if it’s not in his culture or habits.

7. Maybe ask the grieving people to contact (phone) you after a few days and give them time to speak about the way they experience the bereavement process. It is recognition of their grief and an empathetic gesture on your part.

These are just a few examples. I have to remind the reader that it is not the job of a veterinarian to help people go through the bereavement process, but he (she) will not want to appear rude or un-empathetic. Even if only focusing on the subject of
the animal, a veterinarian may be helpful because he (she) is in the first line of interaction with the grieving people.

One may ask oneself if animals may suffer from grief and bereavement. Animals do endure loss. One example is the loss of the primary attachment to the mother or foster figure. It causes distress and even anxiety.

Primary detachment is the corollary process of primary attachment and induces the reduction of primary attachment to facilitate secondary attachment and autonomy. It begins with the eruption of the lacteal teeth and ends at puberty.

Detachment of a secondary attachment is a normal process in bereavement and in the transfer of attachment to other individuals, objects or environments.

Detachment and attachment are normal, complementary, unavoidable processes for the development of the social personality of the animal.

The brutal rupture of a primary attachment (violent primary detachment) may lead to acute posttraumatic-like stress syndrome, possibly lethal. An excess of secondary detachment may lead to anxiety or depressive disorders.

Everybody has seen dogs or cats walking around or sleeping with special toys, which seem to have appeasing effects. This could be an example of a transitional object. But the best transitional object is the environment in the whole. Attachment to the
environment, the house, the special room in which the animal is staying, has an appeasing effect. This is particularly true for the cat who needs a specific organisation of the space and who is quite easily distressed by the smallest change in its
surroundings. This space disorganisation may cause as much distress reaction for a cat as the loss of an attachment individual for a dog or for people.

The same way as pets are socialised to people, people get socialised to animals. These companion animals become a "structural" part of their personal well being. One may say that people are imprinted with their pets. And this picture may
really be true.

For such people, replacing a deceased pet is unavoidable. They will have to do it sooner or later.

And the veterinarian may face three situations:

1. the replacement pet comes after the bereavement period and is adopted as a "new" pet;

2. the replacement pet is adopted during a normal bereavement period and may help repair the damaged affection (friendship, companionship, closeness);

3. the replacement pet is adopted during a complicated or pathological bereavement period and he may develop a specific anxiety disorder, named the "replacement pet disorder"

The owner creates a new relationship with the new pet. This is new in all the different registers of communication (behaviour, emotion, cognition). He may be compared to the lost pet (owners do learn from their experience), but it does not affect the
emotional relationship. It may affect the teaching competence of the owners and their social organisation. But even if the pet is considered a member of the family, he is not associated to the lost pet in the owner’s affects and cognitions.

When the owner purchases a new pet during the bereavement period, he (she) may transfer part of the lost attachment to the new pet that acquires several identification elements from the lost pet. This new pet plays the role of a transitional object. As
all transitional objects he may be discarded or kept after the detachment has occurred and the new attachment has taken place. Often, it is kept as the new attachment figure. The new pet can help speed up the process of bereavement. That is why he is
called a repairing or therapeutic entity.

When the owner purchases a new pet during problem bereavement, he (she) may transfer part or all of the lost attachment to the new pet that acquires several identification elements from the lost pet. The new pet is compared to the lost one. In the
owner's representation, the dead pet has lost all of his defects and has kept only qualities; he is worshipped. It is quite impossible for the new pet to get level with the dead one. The new dog (a real dog is no competition for a worshipped dead
animal) is faced with love and rejection messages. Therefore, the replacement pet is submitted to incongruent messages from his owner(s). This has been named the "double bind" by the Palo Alto school of systemic (family) therapy .

It is the simultaneous or successive emission of two contradictory (conflicting) messages by the same individual in two different registers of communication (behaviour, emotion, cognition) in a situation of close attachment. The animal is
obliged to take a decision on one of the two messages to propose an adaptive response to one of the two messages, which is inevitably a maladjusted response to the other one. The double bind is a testimony of a serious communication or mental
dysfunction of the sender of the message. The human being is the only species, which is able to dissociate affectivity, cognition and behaviours. The double bind may facilitate anxiety disorders.

The medication for a dog with such a disorder will depend on the symptoms, not on the diagnosis. Drugs like selegiline, sertraline, fluvoxamine, etc. could all be effective depending on the symptoms.

Re-establishing congruent communications is another matter entirely. This is human psychotherapy. It is not easy to change people's beliefs and representations during bereavement, especially during problem bereavement. One way to do it is to make
people recognize and dissociate the three registers of communication: behaviour, emotion, and cognition. They cannot change anything about the emotions and representations about the dead pet. However, they can do something about the communication
(behaviour) with the new pet. For example:

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"you have the right to be distressed and sad about the loss of your pet, and you are right to grieve for him. Not to grieve for him would be un-respectful towards him. But here you have a new dog (cat) that does not have anything to do with
your lost beloved pet. Both animals need your respect and your love, this one needs also to be cared for."

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"This pet is not as pretty as the lost one. And he will never be. You will never forget your lost pet. Don’t even think you can forget him. No way. This pet is not as intelligent. That’s right. But all he wants is to get some of your
attention, of your care and your love. Even if you like him, you’ll never forget your loving deceased pet."

The systemic paradigm theorises that communication does not take place in an action-reaction dyadic mode but in a circular mode. Any intervention is not focused on a specific individual but on the interactions inside a group.

In the replacement pet syndrome, the owner, the new pet and the lost pet constitute the group. This is a way to implement a triadic relationship. It recognizes the (affective) existence of the lost pet and the reality of the new pet. They are not
superimposed anymore, but differentiate. The owner is not denied his current affective relation with the lost pet. And saying it loudly – writing it down - gives it a reality. The owner does not have to conceal his (hidden) feelings anymore. He can
still love the lost pet and begin to like (or love) the new animal, as a different individual.

The easiest way for a veterinarian to do a systemic intercession is to write down or prescribe what the owner is already doing but reframing it in a prescriptive way or as a requirement. For example:

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"I am a veterinarian and I am not a psychologist. But I think that you are still grieving X (the lost pet) and only time will help you go through it"

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"you have to continue to love and cherish the lost pet and think about him at least several times a day; when you remember him, please do think only about him and nothing else"

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"you have to walk the new pet and think only about him at that moment; if your mind is wandering elsewhere or on other subjects, please make only short walks"

Insist on the characterisation of the differences between both animals without a qualitative comparison or a judging assessment. One is not better, quieter, taller, … than the other. The lost pet was quiet, the new one is active. The lost pet was 5
years old, the new pet is 5 months old. The lost pet was eating carefully, the new pet is eating ravenously. For example:

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"when you feed the new pet, try to observe how he eats, and to figure out what are the differences between him and the lost pet"

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"This is a sheet of paper divided in two columns. In the left one, you write what the new pet is doing. In the right one, write what X (the lost pet) was doing in the same circumstances. Then, on reading the left column, determine what you
like and you do not like. We will work to improve which behaviour you do not like"

The techniques described here are widespread in several human psychotherapies. The specificity of the systemic intervention is the focus on the system.